Physical activity recommendations for adolescents with anorexia nervosa: An existing protocol based on physical activity risk

Abstract

AimThere is a critical gap between the literature pertaining to physical activity (PA) in eating disorders and directives regarding the management of PA. There is evidence that managed PA in eating disorders is beneficial, as long as it accounts for compulsive exercise. The goal of this paper is to encourage future research to test the efficacy and safety of the existing protocol, leading to the development of clinical practice guidelines to optimize care. MethodA protocol developed for the purpose of individual prescription of PA for adolescents receiving inpatient treatment for AN is described. The protocol uses primary complications related to PA and AN to categorize an adolescents level of PA risk as high, moderate or low. The risk factors assessed include; vital sign instability, percentage of Ideal Body Weight and an evaluation of compulsive exercise. PA recommendations are implemented according to the level of PA risk. Two case studies are presented to illustrate the application of the protocol. DiscussionCritical limitations of the research to date regarding managed PA in eating disorders are numerous and a model of compulsive exercise has only recently been proposed, thus restricting the evaluation of existing research. The applicability of the protocol may be limited within Family Based Treatment in outpatient care, where the management of PA is the responsibility of the parents. ConclusionCategorization of PA risk is assessed by the eating disorders team. A physical therapist should be considered for the implementation and management of the proposed PA recommendations according to the level of PA risk.